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Chapter 4 Select Destinations Asia

Burma (Myanmar)

Henry C. Baggett, John Henderson

DESTINATION OVERVIEW

Burma offers visitors a mix of traditional and modern culture. Nearly all of the estimated 5 million travelers passing through the country in 2016 went to see the classic golden temples in Rangoon, Burma’s biggest city. A growing number also took advantage of improving domestic bus and air service to explore cultural traditions or nature in other parts of the country. International flights to Mandalay are also now available from neighboring China, India, and Thailand.

Burma’s varied geography includes highlands, plains, beaches, and more than 800 islands. Many climate zones are found along its river basins and mountain ranges. That diversity extends to languages, which number more than 100. Of the country’s more than 56 million people, about two-thirds can speak or understand Burmese. English is widely spoken in popular visitor destinations.

Religious sites and ancient cities, with their temples and festivals, attract many of Burma’s tourists. Unique architecture and heritage combine at places like Bagan, Kyaiktiyo, and Mrauk U. Nature-based activities such as boating, trekking, and cycling are easily arranged around Inle in hilly Shan State. River cruises along the Ayeyarwady begin or end in Mandalay (see Map 4-11). Ecotourism destinations are developing at the country’s edges. Meditation retreats are also widespread.

In Rangoon, besides visiting the pagodas, tourists enjoy strolls among colonial-era parks and buildings and shopping at Bogyoke Aung San Market. The city’s influences include British, Chinese, and Indian. Those wanting a glimpse of rural life get it with a short ferry ride across the Rangoon River to Dala or by riding the circle train that makes a loop just north of the city.

Climate varies depending on season and elevation. During the dry months between November and February, Yangon and southern Burma average 80°F (27°C) during the day. Further north in that season, nighttime temperatures can drop to 45°–50°F (8°–10°C). Hot season (March to June) and wet season (July to October) are well named.

Local dishes such as mohinga (rice noodles in fish soup), curries, and salads appeal to many visitors, but food hygiene caution is advised. Sanitation and clean water access are improving, but in secondary towns and rural areas they may be inadequate.

Though the country is slowly moving away from decades of authoritarian rule, economic isolation, and ethnic conflict, its governance and people mostly remain poor. While enjoying Burma’s colorful and rustic aspects, visitors may do well to attempt an understanding of the country’s society, human rights, and environment, and tourism’s potential impact on them.

Map 4-11. Burma (Myanmar) destination map

Map 4-11. Burma (Myanmar) destination map

PDF Version (printable)

HEALTH ISSUES

Vaccine-Preventable Diseases

ROUTINE IMMUNIZATIONS

Travelers to Burma should be up-to-date on routine vaccines, including vaccines for tetanus and influenza. Influenza exhibits a seasonal pattern with peaks occurring from June through September, overlapping with the typical rainy season.

OTHER VACCINATIONS

Hepatitis A is transmitted by contaminated food or water and is endemic in Burma; all nonimmune travelers should be vaccinated. Travelers can also reduce the risk of hepatitis A infection by following recommendations for safe food and water (see Chapter 2, Food & Water Precautions). Based on data from US-bound refugees, the prevalence of hepatitis B infection in Burma is high. Hepatitis B vaccination is recommended for most travelers before departure, especially those who might engage in activities that increase risk to body fluid exposure, such as unprotected sexual contact, injection drug use, tattooing, or providing medical care.

Typhoid and other diseases transmitted by contaminated food and water are common, and typhoid vaccine is recommended.

Rabies vaccination is recommended for travelers participating in extensive outdoor activities, such as camping or caving, that could increase their risk of animal bites. Vaccination is also recommended for travelers working with animals, such as veterinarians, and for young children, for whom it can be difficult to prevent interaction with dogs or other animals.

Japanese encephalitis (JE) is presumed to be endemic throughout Burma, so travelers should take precautions to avoid mosquito bites (see Chapter 2, Protection against Mosquitoes, Ticks, & Other Arthropods). Travelers should consider obtaining JE vaccine if they will be in Burma for >1 month or if their itineraries include higher-risk activities such as spending substantial time in rural areas, especially in the evening or at night; outdoor activities (such as camping, hiking, or farming); or staying in accommodations without air conditioning, window or door screens, or bed nets.

Malaria and Other Vectorborne Diseases

Malaria is present in all areas of Burma below altitudes of 3,281 ft (1,000 m), including Bagan, and the risk to travelers is considered moderate. The incidence of malaria in Burma is higher than that of neighboring countries in the Greater Mekong Subregion and is concentrated in and around forested areas. Drug-resistant malaria has been and continues to be a concern in Burma, and chemoprophylaxis recommendations vary accordingly. For travelers to Bago, Kachin, Kayah, Kayin, Shan, and Tanintharyi, atovaquone-proguanil or doxycycline is recommended but not mefloquine; for other malaria risk areas, atovaquone-proguanil, doxycycline, or mefloquine can be used. Other vectorborne infections endemic in Burma include dengue and chikungunya.

Zika is endemic in Burma; the risk to travelers is unknown but believed to be low. Because of the risk of birth defects in babies born to women who were infected with Zika while pregnant, women who are pregnant or planning to become pregnant should not travel to Burma. If they decide to travel, they should strictly follow steps to prevent mosquito bites. Travelers should consult the CDC Travelers’ Health website (www.cdc.gov/travel) for the most current recommendations for Zika.

Leptospirosis

Leptospirosis is a bacterial disease usually transmitted through contact with water contaminated with the urine of infected animals (see Chapter 3, Leptospirosis). It occurs most commonly during the rainy season. Travelers should avoid contact with soil and water that could be contaminated, and cover any open wounds to prevent exposure. Skin wounds that have been contaminated with soil or water should be immediately and thoroughly cleaned.

Travelers’ Diarrhea

Travelers’ diarrhea is common among visitors to Burma (see Chapter 2, Travelers’ Diarrhea). Travelers should follow safe food and water recommendations, including eating food that is cooked and served hot and drinking only bottled water. Oral rehydration solution is helpful in severe cases of diarrhea and is usually available in pharmacies.

Other Health and Safety Risks

ROAD TRAFFIC INJURIES

Vehicular crashes are a leading cause of injury and death among travelers to Burma. Visitors should use only reputable taxi or public transportation companies and always wear seat belts. Motorcycles account for a high percentage of road traffic deaths and should be avoided. Pedestrians and bicyclists are also commonly victims of road traffic deaths and should exercise caution; right-of-way rules and infrastructure improvements (such as crosswalks or bike lanes) to protect these groups are often not followed or not in place.

HEAT-RELATED ILLNESSES

Average high temperatures in the hot season (March to June) can exceed 95°F (35°C) in many parts of Burma, including popular tourist destinations such as Rangoon, Mandalay, and Bagan. Prolonged heat exposure, especially for travelers in poor physical condition, elderly or very young travelers, and those not accustomed to heat, poses a risk for heat-related illnesses such as heat exhaustion or heat stroke. During periods of high heat, travelers should take precautions to reduce risk of heat-related illnesses, including drinking ample water and wearing lightweight, loose, and light-colored clothing (see Chapter 2, Problems with Heat & Cold).

HEALTH CARE ACCESS

Travelers with chronic medical conditions should not rely on being able to purchase or refill medications in Burma; counterfeit and substandard medications are common. International-standard medical care is rarely available, so treatment of chronic disease exacerbations or severe injuries can be suboptimal. Travelers should strongly consider medical evacuation insurance.

BIBLIOGRAPHY

  1. Agency CI. The World FactBook: Burma. Central Intelligence Agency; 2016 [updated 2016 Sep.; cited 2016 Sep. 23]; Available from: https://www.cia.gov/library/publications/the-world-factbook/geos/bm.html.
  2. Cheng AC, Currie BJ. Melioidosis: epidemiology, pathophysiology, and management. Clin Microbiol Rev. 2005 Apr;18(2):383–416.
  3. Cui L, Yan G, Sattabongkot J, Cao Y, Chen B, Chen X, et al. Malaria in the Greater Mekong Subregion: heterogeneity and complexity. Acta Trop. 2012 Mar;121(3):227–39.
  4. Dapat C, Saito R, Kyaw Y, Naito M, Hasegawa G, Suzuki Y, et al. Epidemiology of human influenza A and B viruses in Myanmar from 2005 to 2007. Intervirology 2009;52(6):310–20.
  5. Hills SL, Rabe BR, Fischer M. Infectious diseases related to travel. Atlanta, GA: CDC; 2016 [updated 2015 July; cited 2016 Sep. 24]; Available from: /travel/yellowbook/2016/infectious-diseases-related-to-travel/japanese-encephalitis.
  6. Hotez PJ, Bottazzi ME, Strych U, Chang LY, Lim YA, Goodenow MM, et al. Neglected tropical diseases among the Association of Southeast Asian Nations (ASEAN): overview and update. PLoS Negl Trop Dis 2015;9(4):e0003575.
  7. Lo E, Nguyen J, Oo W, Hemming-Schroeder E, Zhou G, Yang Z, et al. Examining Plasmodium falciparum and P. vivax clearance subsequent to antimalarial drug treatment in the Myanmar-China border area based on quantitative real-time polymerase chain reaction. BMC Infect Dis 2016 Apr 16;16(1):154.
  8. Mixson-Hayden T, Lee D, Ganova-Raeva L, Drobeniuc J, Stauffer WM, Teshale E, et al. Hepatitis B virus and hepatitis C virus infections in United States-bound refugees from Asia and Africa. Am J Trop Med Hyg 2014 Jun;90(6):1014–20.
  9. Republic of the Union of Myanmar. The 2014 Myanmar population and housing census: highlights of the main results. Census Report. Nay Pyi Taw: Department of Population MoIaP; 2015 May. Available from: http://myanmar.unfpa.org/sites/default/files/pub-pdf/Census_Provisional_Results_2014_ENG_0.pdf.
  10. U.S. Department of State. U.S. Passport & International Travel: Burma (Myanmar). USDS; [cited 2016 May 7]; Available from: https://travel.state.gov/content/passports/en/country/burma.html.
  11. World Health Organization. Global status report on road safety 2013. WHO; 2013 [cited 2016 May 7 ]; Available from: http://www.who.int/violence_injury_prevention/road_safety_status/2013/en/.
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